Older adults with type 1 diabetes face big dangers from low blood sugar drops they often fail to notice early. Continuous glucose monitors track sugars round the clock and cut these lows, but do they sharpen dulled warnings in high-risk seniors? 
A close look at the WISDM trial gives answers, following CGM use for 52 weeks. They checked the Clarke test at start, 26 weeks, and 52 weeks—full score and two parts: one on awareness loss and one on past severe lows. This split view reveals CGM strengths and weak spots for doctors. The study was published in Diabetes Care. 
Past Severe Lows Drop with Monitor Use
In 184 patients at 26 weeks and 94 at 52 weeks, the severe low history score—Clarke-SHEF—fell a lot. It hit significance at P=0.02 early and P under 0.0001 at year end.
Warning Sense Stays Mixed by Test Type
The full Clarke score and awareness section, the Clarke-HAF, did not change much overall. Yet in patients with poor awareness, the full score got better at 52 weeks while the awareness section was unchanged. Test choice shapes results.
Tips for Safer Care in Older Patients
Doctors see CGM as a shield against crashes, but pair it with education for lasting awareness gains.